- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $3,235.94 / $7,244.36
| Facility | | $275.42 | $3,235.94 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Facility | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $691.83 / $831.76
| Professional | | $537.03 | $691.83 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $630.96 / $1,071.52
| Professional | | $512.86 | $630.96 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $457.09 / $831.76
| Facility | | $251.19 | $457.09 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $309.03 / $6,918.31
| Facility | | $223.87 | $309.03 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $7,079.46 / $14,125.38
| Facility | | $3,715.35 | $7,079.46 | $14,125.38 |